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Cushing disease in a toddler: not all obese children are just fat

Megan Moriarty1, Francis Hoe

  • 1Division of Endocrinology, Department of Pediatrics, University of Colorado Denver, Aurora, Colorado 80045, USA. moriarty.megan@tchden.org

Current Opinion in Pediatrics
|June 13, 2009
PubMed

Insights

Cushing disease is rare in infants. Early identification of symptoms like hypertension and slowed growth in obese infants is crucial for timely diagnosis and treatment of this serious condition.

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Endocrinology and Metabolism
  • Rare Pediatric Diseases

Background:

  • Cushing disease is exceptionally rare in children younger than 2 years.
  • Infantile Cushing disease presents diagnostic challenges due to overlapping symptoms with common pediatric conditions.
  • Obesity in infants is increasingly prevalent, often attributed to nutritional factors.

Observation:

  • An 18-month-old female presented with morbid obesity, diminished linear growth, and developmental regression.
  • Diagnostic delay occurred, but surgical excision of a pituitary microadenoma was successful.
  • Post-surgery, Cushing syndrome symptoms resolved, hypertension normalized, and linear growth improved.

Findings:

  • The patient experienced developmental progress but persistent developmental delay and new-onset hypopituitarism.
  • Review of infantile Cushing disease cases highlights key indicators: hypertension and slowed linear growth.
  • These specific signs differentiate Cushing disease from nutritional obesity in infants.

Implications:

  • Recognizing specific clinical features like hypertension and growth deceleration is vital for diagnosing infantile Cushing disease.
  • Prompt diagnosis and surgical intervention can lead to symptom resolution and improved outcomes.
  • This case underscores the importance of considering rare endocrine disorders in overweight infants with atypical growth patterns.

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